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Baird, M.B., O'Connor, R.E., Williamson, A.L., Sojka, B., Alibertis, K. & Brady, W.J. (2010), "The impact of warm weather on mass event medical need: a review of the literature", The American Journal of Emergency Medicine. Vol. 28(2), pp. 224-229.
Abstract: Over the last 20 years, interest in medical need at mass events has increased. Many studies have been published identifying the characteristics of such events that significantly impact the number of patients who seek care. Investigators agree that weather is one of the most important variables. We performed a literature search using several biomedical databases (MEDLINE via PubMed, the Cochrane database, BMJ's Clinical Evidence compendium, and Google Scholar) for articles addressing the effect of weather on medical need at mass events. This search resulted in 8 focused articles and several other resources from the reference sections of these publications. We found that the early literature is composed of case reports and predominantly subjective observations concerning the impact of weather on medical need. Most investigators agree upon a positive relationship between heat/humidity and the frequency of patient presentation. More recent authors make attempts at quantifying the relationship and propose prediction models for patient volume and medical personnel requirements. We present an ancestral review of these studies, discuss their results collectively, and propose a simplified algorithm for predicting patient volume at mass events. This review is intended for event planners and mass event emergency medical personnel for planning future events. We also hope to stimulate further study to develop and verify prediction models.
  author = {Matthew B. Baird and Robert E. O'Connor and Allen L. Williamson and Benjamin Sojka and Kostas Alibertis and William J. Brady},
  title = {The impact of warm weather on mass event medical need: a review of the literature},
  journal = {The American Journal of Emergency Medicine},
  year = {2010},
  volume = {28},
  number = {2},
  pages = {224--229},
  url = {http://www.ajemjournal.com/article/S0735-6757(08)00783-3/abstract},
  doi = {http://dx.doi.org/10.1016/j.ajem.2008.10.034}
Boyer, C., Ammirati, C., Thiebaut, H. & Nemitz, B. (1999), "Couverture médicale des rassemblements de foule : essai de modélisation", Médecine de catastrophe -- urgences collectives. Vol. 2, pp. 24-30.
Abstract: L'objectif de cet article est d'analyser les facteurs de risque et les besoins médicaux pour les rassemblements de plus de 5 000 personnes en France. Une hypothèse sur un nombre d'équipe médical nécessaire pour 10 000 spectateurs en fonction du type d'événement a été avancée à partir d'un calcul ≪ temps-médecin ≫. Pour cela, un questionnaire a été envoyé à tous les Samu et SDIS de France et la littérature a été étudiée ; 179 événements ont été rapportés et analysés. L'étude statistique comparée à celle de la littérature nous a permis d'évaluer le nombre et la gravité des pathologies en fonction du type d'événement et de la quantité de population. II ressort de cette étude que pour un certain nombre d'événements, en particulier le football et les concerts de musique, il est possible de calculer une couverture médicale suffisante et pertinente pour 95 % de l'ensemble des événements, en tenant compte des probabilités de risques médicaux (issues des statistiques), du type de couverture médicale envisagée (médicalisation ou non des postes de secours, présence d'un poste médical avancé et/ou d'un poste de commandement), du temps consacré au tri et à la prise en charge des pathologies. Cette approche objective ne prend pas en compte les risques non connus par le responsable médical et la situation de catastrophe qui peut en découler. Afin d'infirmer ou confirmer ces hypothèses, un observatoire national a été crée à Amiens au Samu 80. Il permettra à partir de fiches types envoyées à tous les Samu et SDIS de France de recueillir des données précises sur les aspects médicaux de chaque rassemblement de foule.
  author = {C. Boyer and C. Ammirati and H. Thiebaut and B. Nemitz},
  title = {Couverture médicale des rassemblements de foule : essai de modélisation},
  journal = {Médecine de catastrophe -- urgences collectives},
  year = {1999},
  volume = {2},
  pages = {24-30},
  url = {http://www.sciencedirect.com/science/journal/12798479}
Enock, K.E. & Jacobs, J. (2008), "The Olympic and Paralympic Games 2012: Literature review of the logistical planning and operational challenges for public health", Public Health. Vol. 122, pp. 1229-1238.
Abstract: Summary Objective: To undertake a review of the literature relating to public
health planning and interventions at previous summer Olympic and Paralympic
Games and other relevant major summer sporting events or mass gatherings, with
a focus on official publications and peer-reviewed articles.
Study design: Literature review.
Methods: A literature review was undertaken using all biomedical databases and
a freetext search usingGoogle to widen the search beyond peer-reviewed publications.
Search terms usedwere: Olympics; Paralympics;mass gatherings;mass gatheringmedicine;
sporting events; weather; planning; and organisation. Citations within articles
were searched to identify additional references that would informthis review. This literature
review concentrates on the public health aspects of population care at mass
gatherings, particularly the Olympic and Paralympic Games which are set over several
weeks, focusing on surveillance, prevention and health service quality.
Results: The literature identified 10 areas of public health planning: public health
command centre and communication; surveillance, assessment and control; environmental
health and safety; infectious disease outbreaks; implications of weather conditions;
health promotion; travel information; economic assessments; public transport
and reduction of asthma events; and preparing athletes for potential allergies. The following
themesemerged as crucial factors for the success of any public health interventions
at Olympic and Paralympic Games: detailed planning of deliverables; preidentification
of critical success factors; management of risk; detailed contingency
planning; and full testing of all plans prior to the event.
Conclusions: The 2012 Olympic Games will provide an exciting challenge for public
health providers and systems. Preparation requires early detailed planning of
policies, procedures and on-site health promotion events, in addition to helping to
* Corresponding author. Tel.: þ44 7952 200157; fax: þ020 7594 0866.
E-mail address: katieenock@aol.com (K.E. Enock).
0033-3506/$ - see front matter ª 2008 The Royal Institute of Public Health. Published by Elsevier Ltd. All rights reserved.
Public Health (2008) 122, 1229e1238
set up the surveillance and monitoring systems that will capture public health activity
alongside medical activity. Learning from the literature review will support the identification
of critical success factors and help to formulate recommendations that will allow
optimal utilization of public health initiatives. All plans require full costings in
advance which are supported by internal and external health-related agencies, voluntary
organizations and sponsors. A risk assessment should be undertaken as part of the
planning process leading to risk management plans for mitigating identified potential
risks. All surveillance andmonitoring systems, communication, policies and procedures
will require full testing prior to commencement of the Games.
  author = {K. E. Enock and J. Jacobs},
  title = {The Olympic and Paralympic Games 2012: Literature review of the logistical planning and operational challenges for public health},
  journal = {Public Health},
  year = {2008},
  volume = {122},
  pages = {1229-1238},
  url = {http://www.publichealthjrnl.com/article/S0033-3506%2808%2900122-4/abstract}
Johansson, A., Batty, M., Hayashi, K., Bar, O.A., Marcozzi, D. & Memish, Z.A. (2012), "Crowd and environmental management during mass gatherings", Lancet Infect Dis. Vol. 12, pp. 150-156.
  author = {Anders Johansson and Michael Batty and Konrad Hayashi and Osama Al Bar and David Marcozzi and Ziad A Memish},
  title = {Crowd and environmental management during mass gatherings},
  journal = {Lancet Infect Dis},
  year = {2012},
  volume = {12},
  pages = {150-156},
  url = {http://press.thelancet.com/mg4.pdf}
Landry, P. & Slama, S. (2008), "Pèlerinages et grands rassemblements : épidémiologie et prévention", Rev Med Suisse. Vol. 4, pp. 1192-1195.
  author = {Pierre Landry and Slim Slama},
  title = {Pèlerinages et grands rassemblements : épidémiologie et prévention},
  journal = {Rev Med Suisse},
  year = {2008},
  volume = {4},
  pages = {1192-1195},
  url = {http://rms.medhyg.ch/numero-157-page-1192.htm}
Lekka, C., Webster, J. & Corbett, C.E. (2010), "A literature review of the health and safety risks associated with major sporting events -- Learning lessons for the London 2012 Olympic and Paralympic games" (RR811)
Abstract: This work was commissioned by the Health and Safety Executive (HSE) to provide an understanding of the potential hazards and risks associated with hosting the Olympic Games in Great Britain in 2012, as well as potential control measures that could be applied to these. The literature search yielded 384 papers, of which 80 met the inclusion criteria. These papers were then reviewed by the research team and summarised by emergent topics. The topics included: construction, public health and safety risks, road accidents, injuries, musculoskeletal disorders (MSDs), crowd safety, emergency planning and response, volunteers, workplace violence, fire safety, electrical hazards and carbon monoxide/gas safety.
Each of the topics is summarised by the risks identified from previous Olympic events and major sporting events, followed by controls that were applied or identified as potentially useful. The controls often provided practical ways to reduce risks, or to mitigate negative outcomes.
  author = {Chrysanthi Lekka and Jennifer Webster and CPsychol Edward Corbett},
  title = {A literature review of the health and safety risks associated with major sporting events -- Learning lessons for the London 2012 Olympic and Paralympic games},
  year = {2010},
  number = {RR811},
  url = {http://www.hse.gov.uk/research/rrpdf/rr811.pdf}
Lombardo, J.S., Sniegoski, C.A., Loschen, W.A., Westercamp, M., Wade, M., Dearth, S. & Zhang, G. (2008), "Public Health Surveillance for Mass Gatherings", Johns Hopkins APL technical digest., {http://cat.inist.fr/?aModele=afficheN\&cpsidt=20437292}. Vol. 27, pp. 347-355.
  author = {Joseph S. Lombardo and Carol A. Sniegoski and Wayne A. Loschen and Matthew Westercamp and Michael Wade and Shandy Dearth and Guoyan Zhang},
  title = {Public Health Surveillance for Mass Gatherings},
  journal = {Johns Hopkins APL technical digest},
  year = {2008},
  volume = {27},
  pages = {347-355},
  url = {http://cat.inist.fr/?aModele=afficheN&cpsidt=20437292}
Lund, A., Gutman, S.J. & Turris, S.A. (2011), "Mass gathering medicine: a practical means of enhancing disaster preparedness in Canada", Canadian Journal of Emergency Medicine. Vol. 13, pp. 231-236.
  author = {Adam Lund and Samuel J. Gutman and Sheila A. Turris},
  title = {Mass gathering medicine: a practical means of enhancing disaster preparedness in Canada},
  journal = {Canadian Journal of Emergency Medicine},
  year = {2011},
  volume = {13},
  pages = {231-236},
  url = {http://www.cjem-online.ca/v13/n4/p231}
McQueen, C. & Davies, C. (2012), "Health care in a unique setting: applying emergency medicine at music festivals", Open Access Emergency Medicine. Vol. 4, pp. 69-73.
  author = {C. McQueen and C. Davies},
  title = {Health care in a unique setting: applying emergency medicine at music festivals},
  journal = {Open Access Emergency Medicine},
  year = {2012},
  volume = {4},
  pages = {69-73},
  url = {http://www.dovepress.com/health-care-in-a-unique-setting-applying-emergency-medicine-at-music-f-peer-reviewed-article-OAEM}
Milsten, A.M., Maguire, B.J., Bissell, R.A. & Seaman, K.G. (2002), "Mass-gathering medical care: a review of the literature", Prehosp Disaster Med., September, 2002. Vol. 17(3), pp. 151-162.
Abstract: Mass-gatherings events provide a difficult setting for which to plan an appropriate emergency medical response. Many of the variables that affect the level and types of medical needs, have not been fully researched. This review examines these variables. METHODS: An extensive review was conducted using the computerized databases Medline and Healthstar from 1977 through May 2002. Articles selected contained information pertaining to mass-gathering variables. These articles were read, abstracted, analyzed, and compiled. RESULTS: Multiple variables are present during a mass gathering, and they interact in complex and dynamic ways. The interaction of these variables contributes to the number of patients treated at an event (medical usage rate) as well as the observed injury patterns. Important variables include weather, event type, event duration, age, crowd mood and density, attendance, and alcohol and drug use. CONCLUSIONS: Developing an understanding of the variables associated with mass gatherings should be the first step for event planners. After these variables are considered, a thorough needs analysis can be performed and resource allocation can be based on objective data.
  author = {Andrew M Milsten and Brian J Maguire and Rick A Bissell and Kevin G Seaman},
  title = {Mass-gathering medical care: a review of the literature},
  journal = {Prehosp Disaster Med},
  year = {2002},
  volume = {17},
  number = {3},
  pages = {151--162},
  note = {PMID: 12627919},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/12627919}
Sanders, A.B., Criss, E., Steckl, P., Meislin, H.W., Raife, J. & Allen, D. (1986), "An analysis of medical care at mass gatherings", Ann Emerg Med.. Vol. 15, pp. 515-519.
Abstract: Emergency medical care at public gatherings is haphazard at best and dangerous at worst. The Arizona chapter of the American College of Emergency Physicians, through the Chapter Grant Program, studied the level of medical care provided at public gatherings in order to develop guidelines for emergency medical care at mass gatherings. The study consisted of a survey of medical care at 15 facilities providing events for the public. The results of these surveys showed a wide variation of medical care provided at mass events. Of the 490 medical encounters reviewed, 52.2% were within the realm of care of paramedics, but not basic emergency medical technicians. The most common injuries/illnesses were lacerations, sprains, headaches, and syncope. Problems noted included poor documentation and record keeping of medical encounters, a tendency for prehospital care personnel to make medical evaluations without transport or medical control, and variability of care provided. Based on this survey and a literature review, guidelines for medical care at mass gatherings in Arizona were determined using an objective-oriented approach. It is our position that event organizers have the responsibility of ensuring the availability of emergency medical services for spectators and participants. We recommend that state chapters or National ACEP evaluate the role of emergency medical care at mass gatherings.
  author = {Arthur B Sanders and Elizabeth Criss and Peter Steckl and Harvey W Meislin and John Raife and Douglas Allen},
  title = {An analysis of medical care at mass gatherings},
  journal = {Ann Emerg Med.},
  year = {1986},
  volume = {15},
  pages = {515-519},
  url = {http://www.annemergmed.com/article/S0196-0644(86)80984-2/abstract}
Steffen, R., Bouchama, A., Johansson, A., Dvorak, J., Isla, N., Smallwood, C. & Memish, Z.A. (2012), "Non-communicable health risks during mass gatherings", Lancet Infect Dis. Vol. 12, pp. 142-149.
  author = {Robert Steffen and Abderrezak Bouchama and Anders Johansson and Jiri Dvorak and Nicolas Isla and Catherine Smallwood and Ziad A Memish},
  title = {Non-communicable health risks during mass gatherings},
  journal = {Lancet Infect Dis},
  year = {2012},
  volume = {12},
  pages = {142-149},
  url = {http://press.thelancet.com/mg3.pdf},
  doi = {http://dx.doi.org/10.1016/S1473-3099(11)70293-6}

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